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目的探讨细胞角蛋白19(CK19)在原发性肝透明细胞癌(PCCCL)中的表达及其与患者预后的关系。方法收集2006年11月~2014年8月首都医科大学附属北京佑安医院术后病理活检证实为PCCCL的住院患者76例。采用免疫组化法检测癌组织CK19、P53、CD34、GPC-3和Hep Par-1表达。应用Kaplan-Meier生存曲线和Wilcoxon检验分析CK19阳性与阴性的PCCCL患者的预后差异。结果在76例PCCCL组织中,CK19阳性9例(11.84%);在肿瘤直径大于3 cm患者,CK19阳性患者发生肿瘤远端转移为60.0%(3/5),显著高于CK19阴性患者的8.7%(2/23,P<0.05);经Kaplan-Meier和Log-rank检验,结果显示CK19阴性的PCCCL患者生存期为60 w,显著长于CK19阳性的PCCCL患者(31 w,P<0.05)。结论 PCCCL是一组异质性肿瘤,可以起源于CK19阳性的肝前体细胞,也可能转化自趋于分化成熟的肝细胞。PCCCL组织CK19阳性表达与患者的不良预后密切相关。
Objective To investigate the expression of cytokeratin 19 (CK19) in primary hepatocellular carcinoma (PCCCL) and its relationship with the prognosis of patients. Methods A total of 76 hospitalized patients with PCCCL confirmed by postoperative biopsy of Beijing You’an Hospital Affiliated to Capital Medical University from November 2006 to August 2014 were collected. The expression of CK19, P53, CD34, GPC-3 and Hep Par-1 were detected by immunohistochemistry. Kaplan-Meier survival curves and Wilcoxon test CK19 positive and negative PCCCL patients with prognosis differences. Results Among 76 PCCCL tissues, CK19 was positive in 9 cases (11.84%). The tumor distant metastasis was 60.0% (3/5) in CK19 positive patients with tumor diameter> 3 cm, which was significantly higher than that in CK19 negative patients % (2/23, P <0.05). The Kaplan-Meier and Log-rank test showed that the survival of patients with CK19-negative PCCCL was 60 w, significantly longer than that of CK19-positive patients with PCCCL (31 w, P <0.05). Conclusions PCCCL is a heterogeneous group of tumors that can originate from CK19-positive hepatic progenitor cells and may also transform into hepatocytes that tend to differentiate into mature cells. The positive expression of CK19 in PCCCL tissue is closely related to the poor prognosis of patients.